Georgetown Doctors

What Are The Different Types of Tummy Tuck? What Is Best For My Case After Massive Weight Loss?

I have heard the tummy tuck called extended, anchor cut, fleur de lis and full abdominalplasty. Can you explain the difference in these, when they are use and if there is a cost difference between them. Can any of them be used when having a lower body lift? I had open RNY bypass surgery six years ago and lost 150 lbs. I am now considering plastics to finish what I started. Tess

You are absolutely correct.  There are many ways of performing a tummy tuck.  Massive weight loss typically results in a lot of extra abdominal skin and this is frequently more severe than our standard mom with three kids.  A physical exam helps us to determine what technique suites your personal needs most.  In patients who have a circumferential excess of skin at their trunk and want improvement in the abdomen, hips, and buttock region, a lower body lift (or you may see the words extended tummy tuck or circumferential tummy tuck/belt lipectomy) may serve the patient best.  It can helps with the extra skin all the way around the body.  This prolongs the time of procedure, cost, and some of the risks such as wound healing problems.  But, it can result in a powerful improvement.  Other patients are more concerned with the abdomen itself with most of the redundant skin being there.  If the extra skin is modest to moderate, a standard tummy tuck (removing a wedge of lower abdominal skin, repairing the underlying muscle, and bringing the upper skin down like a window shade) resulting in a low lying scar reaching from hip to hip may serve the patient well.  The fleur di lis (may also be referred to as an anchor shaped or upside down T shaped scar) is also a powerful manuver when patients want to avoid the circumferential surgery but have a lot of excess skin such that they need a vertically oriented excision and a horizontally oriented excision in order to remove the skin and bring the abdomen in to reach that pleasing and flat contour.  This winds up giving you a central, vertical (up and down) scar combined with the lower horizontal scar of a standard tummy tuck.  The belly button ends up being placed within that vertical scar line. 

I suggest a consult with a board certified plastic surgeon to determine your best option for your particular skin issues.  Tummy tucks are initially tough on the patient for a week or two but offer such a nice, dramatic effect in weight loss patients with extra skin that it is well worth it.  Good luck! 

Jennifer Lauren Crawford, MD

Austin Plastic Surgeon

6 Weeks Post Op From Full Tummy Tuck with Lipo and Muscle Repair, Normal To Feel Pain on One Side?

hi i am 6 weeks post op from full tummy tuck with lipo muscle repair and breast uplift ,at the moment i am suffering from a real bad pain only on one side of my abdomen ,it feels like it is internal bruising ,is this normal there is no extra swelling and all scars are healing amazingly i went back to work (childrens entertainer )on day 15 and also have a two year old who i started lifting again after two weeks ,i just need advice as to whether this is to be expected cheers

Yes, I do feel that it is normal to feel some pain at this point.  This discomfort may even be worsened as you become more active and start using your abdominal muscles more.  It is also quite possible that you were simply more bruised on one side.  I am glad to hear that everything has healed well and that nothin new appears to be swollen.  Sometimes fluid collections can be to blame for discomfort, pressure, and a new site of swelling.  Just check out your symptoms on your next follow up visit with your surgeon to get further reassurance.

Jennifer Lauren Crawford, MD

Austin Plastic Surgeon

Why Does my Face Keep Getting Flatter? Considering Sculptra.

I had buccal fat removed 10 years ago. Within the last 3mos my face keeps losing an inordinate amount of vol. I got Radiesse a month ago, it helped a little. Considering more, but improvement seems to be wearing off. I'm considering getting Sculptra at the same time as Radiesse but... 1. if the fat in my cheeks keeps "burning" off, will Sculptra really help? Can I maintain results? and 2. can you get as much as you want and establish as much volume as you want or will this too "burn" off?

We love Sculptra here in my clinic because it does inspire the building of one's own collagen and it does have a lasting effect of many years (as opposed to most any other type of filler).  Even patients suffering from fat atrophy due to medication causes such as HIV afflicted patients see lasting improvement.  Plus, it is very well tolerated by people's tissues and we have yet to see any nodule formation or allergic reactions to this product.  It is a wonderful choice to get some lasting facial volume. 

Jennifer Lauren Crawford, MD

Austin Plastic Surgeon